Robotics Tool Bailouts

ABSTRACT

Methods and devices are provided for robotic surgery, and in particular for retracting and/or bailing out robotic tools. For example, surgical tools, methods, and systems are provided having bailout assemblies for selectively bailing out one or more functions of an end effector of a surgical tool. Surgical tools, methods, and systems are also provided with bailout assemblies for simultaneously bailing out a plurality of functions of an end effector of a surgical tool.

FIELD OF THE INVENTION

Methods and devices are provided for robotic surgery, and in particularfor retracting and/or bailing out robotic tools.

BACKGROUND OF THE INVENTION

Minimally invasive surgical (MIS) instruments are often preferred overtraditional open surgical devices due to the reduced post-operativerecovery time and minimal scarring. Laparoscopic surgery is one type ofMIS procedure in which one or more small incisions are formed in theabdomen and a trocar is inserted through the incision to form a pathwaythat provides access to the abdominal cavity. The trocar is used tointroduce various instruments and tools into the abdominal cavity, aswell as to provide insufflation to elevate the abdominal wall above theorgans. The instruments and tools can be used to engage and/or treattissue in a number of ways to achieve a diagnostic or therapeuticeffect. Endoscopic surgery is another type of MIS procedure in whichelongate flexible shafts are introduced into the body through a naturalorifice.

Although traditional minimally invasive surgical instruments andtechniques have proven highly effective, newer systems may provide evenfurther advantages. For example, traditional minimally invasive surgicalinstruments often deny the surgeon the flexibility of tool placementfound in open surgery. Difficulty is experienced in approaching thesurgical site with the instruments through the small incisions.Additionally, the added length of typical endoscopic instruments oftenreduces the surgeon's ability to feel forces exerted by tissues andorgans on the end effector. Furthermore, the relative remoteness of theinstruments makes responding to any emergencies and/or errors during thesurgery difficult. For example, if one or more instruments malfunction,it can be desirable to rapidly release any tissue coupled to theinstruments and retract the instruments. But the remote placement of theinstruments and the minimally-invasive nature of the surgery may makethis desire difficult.

Thus it can be desirable to allow rapid release, reversal, and/orretraction of surgical instruments within a patient even if theinstruments experience errors, malfunctions, and/or failures. Whilesignificant advances have been made in the field of robotic surgery,there remains a need for improved methods, systems, and devices for usein robotic surgery.

SUMMARY OF THE INVENTION

Various surgical tools and methods are provided having bailoutassemblies for selectively bailing out one or more functions of the endeffector of the surgical tool. In one embodiment, a surgical tool isprovided and includes a housing having a plurality of motor-driven drivegears, and an elongate shaft extending distally from the housing. An endeffector is coupled to a distal end of the elongate shaft. The devicealso includes a plurality of actuation assemblies. Each actuationassembly can be coupled to one of the plurality of motor-driven drivegears such that each of the motor-driven drive gears is configured todrive a corresponding actuation assembly. Each actuation assembly canalso configured to operate a function of the end effector. The devicecan further include a plurality of bailout mechanisms, with each bailoutmechanism being selectively engageable with one of the plurality ofactuation assemblies for manually driving the actuation assembly.

In one embodiment, each bailout mechanism can include a one-way gearconfigured to selectively engage the actuation assembly and configuredto be rotatable in only one direction to drive the actuation assembly ina reverse direction. The one-way gear can be accessible from an exteriorof the housing and it can be configured to move into engagement with theactuation assembly. The device can also include a rotatable levercoupled to the one-way gear such that rotation of the lever is effectiveto cause corresponding rotation of the one-way gear.

In other aspects, each actuation assembly can be movable from a firstposition in which the actuation assembly is engaged with thecorresponding motor-driven drive gear, to a second position in which theactuation assembly is disengaged with the corresponding motor-drivendrive gear. Each actuation assembly can be configured such that it isprevented from moving from the second position to the first position. Inone embodiment, each actuation assembly can include a gear mounted on ashaft, the gear being engaged with the corresponding motor-driven drivegear in the first position, and the gear moving away from and out ofengagement with the motor-driven drive gear in the second position. Inone embodiment, the shaft can be configured to move with the gear whenthe gear is moved away from and out of engagement with the motor-drivendrive gear, and the shaft can include tabs that engage the housing toprevent movement of the shaft, thereby locking the actuation assembly inthe second position. In other aspects, the gear mounted on the shaft ofeach actuation assembly can be held in engagement with the correspondingmotor-driven drive gear by a spring, and a collar can be disposed on theshaft and is configured to advance over the spring to release the gearthereby allowing the gear to move out of engagement with themotor-driven drive gear.

In other embodiments, the tool can include a decoupling assembly coupledto first and second actuation assemblies of the plurality of actuationassemblies. The decoupling assembly can be configured to simultaneouslycause a first gear of the first actuation assembly and a second gear ofthe second actuation assembly to move out of engagement with thecorresponding motor-driven drive gears. The first actuation assembly canbe effective to close opposed jaws of the end effector, and the secondactuation assembly can be effective to first a plurality of staples fromthe end effector. In certain aspects, the decoupling assembly caninclude a threaded shaft and a housing threadably mounted on thethreaded shaft. The housing can have first and second pusher rods matedthereto and mated to the first and second gears such that rotation ofthe threaded shaft causes translation of the housing such that the firstand second pusher rods push the first and second gears away from thecorresponding motor-driven drive gears.

In another embodiment, each bailout mechanism can include an indicatorconfigured to indicate when the actuation assembly coupled thereto hasfailed. The bailout mechanisms can include other features such as torquelimiters as well.

Surgical bailout methods are also provided and in one embodiment, themethod includes selectively actuating a plurality of motors in a tooldriver of a robotic arm to selectively drive a plurality of drive gearsdisposed within a housing of a surgical tool. Each of the plurality ofdrive gears can drive an actuation assembly extending through anelongate shaft of the surgical tool to thereby actuate a function of anend effector of the tool. The method can further include selectivelymoving a first bailout assembly of a plurality of bailout assembliesinto engagement with a first actuation assembly of the plurality ofactuation assemblies, and manually rotating the first bailout assemblyto retract the first actuation assembly and thereby reverse thecorresponding function of the end effector.

The method can also include decoupling the first actuation assembly fromengagement with the corresponding drive gear. Decoupling the firstactuation assembly can include releasing a spring biasing force appliedto a gear of the first actuation assembly to allow the gear to move outof engagement with the corresponding drive gear. In other aspects, themethod can include simultaneously decoupling the first actuationassembly and a second actuation assembly of the plurality of actuationassemblies from engagement with the corresponding drive gears. Themethod can also include moving the first actuation assembly from a firstposition, in which a gear of the first actuation assembly is positionedin engagement with a corresponding drive gear of the plurality of drivegears, to a second position, in which the gear of the first actuationassembly is spaced apart and disengaged from the corresponding drivegear of the plurality of drive gears. In other embodiments, the methodcan include selectively moving a second bailout assembly of a pluralityof bailout assemblies into engagement with a second actuation assemblyof the plurality of actuation assemblies, and manually rotating thesecond bailout assembly to retract the second actuation assembly andthereby reverse the corresponding function of the end effector.

Various surgical tools and methods are provided having bailoutassemblies for simultaneously bailing out a plurality of functions ofthe end effector of the surgical tool. In one embodiment, a surgicaltool is provided and includes a housing, an elongate shaft extendingdistally from the housing, and an end effector disposed at a distal endof the elongate shaft. The tool also include a plurality of actuationassemblies coupled to a plurality of motor-driven drive gears. Each ofthe motor-driven drive gears is configured to drive a correspondingactuation assembly, and each of the actuation assemblies is configuredto operate a function of the end effector. The tool also includes abailout mechanism configured to manually drive at least two of theplurality of actuation assemblies simultaneously to reverse thecorresponding functions of the end effector.

In one embodiment, each motor-driven drive gear is selectively movablebetween a first position, in which the motor-driven drive gear has acoupling positioned to engage an external motor, and a second position,in which the coupling is positioned such that it is prevented fromengaging an external motor. In other aspects, the bailout mechanism caninclude a crank arm configured to engage and drive the at least twoactuation assemblies simultaneously.

In one embodiment, the bailout mechanism can include a bailout drivegear, and each of the plurality of actuation assemblies can include agear that is selectively movable into engagement with the bailout drivegear such that rotation of the bailout drive gear can simultaneouslydrive at least two of the plurality of actuation assemblies. Each of theplurality of actuation assemblies can be coupled to a switch disposed onthe housing and configured to move the gear of the actuation assemblyinto engagement with the bailout drive gear. Each switch can beconfigured to simultaneously move a corresponding motor-driven drivegear into a position in which the motor-driven drive gear is preventedfrom engaging with an external motor.

In other aspects, the bailout mechanism can be configured to be manuallyrotated to manually drive the at least two actuation assemblies. Thebailout mechanism can include a drive recess configured to receive adrive tool. The drive tool can include a ratchet.

The tool can also include at least one indicator connected to at leastone of the plurality of actuation assemblies and configured to indicatewhen the corresponding actuation assembly has failed. In other aspects,the housing can be configured to couple to a plurality of motors on atool driver of a surgical system.

Bailout methods are also provided and in one embodiment the methodincludes selectively actuating a plurality of motors in a tool driver ofa robotic arm to selectively drive a plurality of drive gears disposedwithin a housing of a surgical tool. Each of the plurality of drivegears drives an actuation assembly extending through an elongate shaftof the surgical tool to thereby actuate a function of an end effector ofthe tool. The method can further include actuating a bailout assembly tosimultaneously counter rotate at least two of the plurality of actuationassemblies to reverse the corresponding functions of the end effector.

In one embodiment, the method further includes, prior to actuating thebailout assembly, decoupling the drive gears of the at least two of theplurality of actuation assemblies from the corresponding motors.Simultaneously with decoupling, the at least two of the plurality ofactuation assemblies can move into engagement with the bailout assembly.In other aspects, decoupling the drive gears of the at least two of theplurality of actuation assemblies from the corresponding motors caninclude actuating a switch to move a coupling on a shaft having thedrive gear mounted thereon away from and out of engagement with themotor.

In another embodiment, actuating the bailout assembly includes rotatinga tool coupled to the bailout assembly to counter rotate the at leasttwo of the plurality of actuation assemblies. Actuating the bailoutassembly can cause a bailout gear to rotate, which in turn causes a gearon each of the at least two of the plurality of actuation assemblies torotate. In other aspects, the tool can include a plurality of indicatorsand each indicator can indicate when an actuation assembly coupledthereto has failed.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 illustrates a perspective view of one embodiment of a surgicalrobotic system that includes a patient-side portion and a user-sideportion;

FIG. 2 illustrates an embodiment of a robotic arm of a surgical roboticsystem with a tool assembly releasable coupled to the robotic arm;

FIG. 3 illustrates a tool driver of the robotic arm of FIG. 2;

FIG. 4 illustrates the tool assembly of FIG. 2 uncoupled from therobotic arm, the tool assembly including a shaft extending from a puckat a proximal end and having an end effector located at a distal end ofthe shaft;

FIG. 5 illustrates the puck of the tool assembly of FIG. 4;

FIG. 6 illustrates an actuation assembly of the puck of FIG. 5;

FIG. 7 illustrates engaged gears of the puck of FIG. 5;

FIG. 8 illustrates the puck of FIG. 5 during bailout;

FIG. 9 illustrates a perspective view of one embodiment of a puck of atool assembly with selective bailout mechanisms;

FIG. 10 illustrates a cross-sectional view of one of the bailoutmechanisms of FIG. 9;

FIG. 11 illustrates a cross-sectional view of the bailout mechanism ofFIG. 10 with a bailout tool engaged;

FIG. 12 illustrates an embodiment of a torque limiter that can be usedwith the puck of FIG. 9;

FIG. 13 illustrates a perspective view of a bailout mechanism of anotherembodiment of a puck of a tool assembly;

FIG. 14 illustrates a perspective view of the bailout mechanism of FIG.13;

FIG. 15 illustrates another perspective view of the bailout mechanism ofFIG. 14;

FIG. 16 illustrates a perspective view of another embodiment of a puckof a tool assembly with bailout mechanisms;

FIG. 17 illustrates a perspective view of the puck of FIG. 16;

FIG. 18 illustrates a side view of the puck of FIG. 16;

FIG. 19 illustrates a perspective view of one embodiment of a puck of atool assembly with bailout mechanisms;

FIG. 20 illustrates a transparent perspective view of the puck of FIG.19 with the bailout mechanisms; and

FIG. 21 illustrates one exemplary embodiment of a computer system havingone or more features consistent with the present description.

DETAILED DESCRIPTION OF THE INVENTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

Further, in the present disclosure, like-named components of theembodiments generally have similar features, and thus within aparticular embodiment each feature of each like-named component is notnecessarily fully elaborated upon. Additionally, to the extent thatlinear or circular dimensions are used in the description of thedisclosed systems, devices, and methods, such dimensions are notintended to limit the types of shapes that can be used in conjunctionwith such systems, devices, and methods. A person skilled in the artwill recognize that an equivalent to such linear and circular dimensionscan easily be determined for any geometric shape. Sizes and shapes ofthe systems and devices, and the components thereof, can depend at leaston the anatomy of the subject in which the systems and devices will beused, the size and shape of components with which the systems anddevices will be used, and the methods and procedures in which thesystems and devices will be used.

Various surgical tools with bailout mechanisms are provided. Roboticsurgical tools generally have a housing and an elongate tool shaftextending from the housing and having an end effector on a distal endthereof. The housing has a plurality of actuators for causing variousfunctions of the end effector, such as rotation, articulation, clamping,firing, stapling, etc. The housing attaches to a tool driver on arobotic arm that electromechanically drives the actuators to control theend effector.

Robotic surgical tools provided herein have various bailout mechanismsin the housing for retracting an actuator or a plurality of actuators inthe event of a failure. Bailout mechanisms provided herein can be usedto selectively bailout individual actuators, and other bailoutmechanisms provided herein can be used to simultaneously bailout one ormore actuators at the same time. Various bailout mechanisms thus allowdirect engagement with one or more actuators to provide rapid andeffective bailout (such as release, reversal, and/or retraction) ofsurgical tools while minimizing the amount of force and/or time tocomplete the bailout.

If the system experiences a gear tooth failure in the gear train, anapproach can be to drive the gears connected to the gear with a geartooth failure and/or drive the gear with a gear tooth failure throughalternative means.

As will be appreciated by a person skilled in the art, electroniccommunication between various components of a robotic surgical systemcan be wired or wireless. A person skilled in the art will alsoappreciate that all electronic communication in the system can be wired,all electronic communication in the system can be wireless, or someportions of the system can be in wired communication and other portionsof the system can be in wireless communication.

FIG. 1 is a perspective view of one embodiment of a surgical roboticsystem 300 that includes a patient-side portion 310 that is positionedadjacent to a patient 312, and a user-side portion 311 that is located adistance from the patient, either in the same room and/or in a remotelocation. The patient-side portion 310 generally includes one or morerobotic arms 320 and one or more tool assemblies 330 that are configuredto releasably couple to a robotic arm 320. The user-side portion 311generally includes a vision system 313 for viewing the patient 312and/or surgical site, and a control system 315 for controlling themovement of the robotic arms 320 and each tool assembly 330 during asurgical procedure.

The control system 315 can have a variety of configurations and it canbe located adjacent to the patient, e.g., in the operating room, remotefrom the patient, e.g., in a separate control room, or it can bedistributed at two or more locations. For example, a dedicated systemcontrol console can be located in the operating room, and a separateconsole can be located in a remote location. The control system 315 caninclude components that enable a user to view a surgical site of apatient 312 being operated on by the patient-side portion 310 and/or tocontrol one or more parts of the patient-side portion 310 (e.g., toperform a surgical procedure at the surgical site 312). In someembodiments, the control system 315 can also include one or moremanually-operated input devices, such as a joystick, exoskeletal glove,a powered and gravity-compensated manipulator, or the like. These inputdevices can control teleoperated motors which, in turn, control themovement of the surgical system, including the robotic arms 320 and toolassemblies 330.

The patient-side portion can also have a variety of configurations. Asdepicted in FIG. 1, the patient-side portion 310 can couple to anoperating table 314. However, in some embodiments, the patient-sideportion 310 can be mounted to a wall, to the ceiling, to the floor, orto other operating room equipment. Further, while the patient-sideportion 310 is shown as including two robotic arms 320, more or fewerrobotic arms 320 may be included. Furthermore, the patient-side portion310 can include separate robotic arms 320 mounted in various positions,such as relative to the surgical table 314 (as shown in FIG. 1).Alternatively, the patient-side portion 310 can include a singleassembly that includes one or more robotic arms 320 extending therefrom.

FIG. 2 illustrates one embodiment of a robotic arm 420 and a toolassembly 430 releasably coupled to the robotic arm 420. The robotic arm420 can support and move the associated tool assembly 430 along one ormechanical degrees of freedom (e.g., all six Cartesian degrees offreedom, five or fewer Cartesian degrees of freedom, etc.).

The robotic arm 420 can include a tool driver 440 at a distal end of therobotic arm 420, which can assist with controlling features associatedwith the tool assembly 430. The robotic arm 420 can also include anentry guide 432 (e.g., a cannula mount or cannula) that can be a part ofor removably coupled to the robotic arm 420, as shown in FIG. 4. A shaft436 of the tool assembly 430 can be inserted through the entry guide 430for insertion into a patient.

In order to provide a sterile operation area while using the surgicalsystem, a barrier 434 can be placed between the actuating portion of thesurgical system (e.g., the robotic arm 420) and the surgical instruments(e.g., the tool assembly 430). A sterile component, such as aninstrument sterile adapter (ISA), can also be placed at the connectinginterface between the tool assembly 430 and the robotic arm 420. Theplacement of an ISA between the tool assembly 430 and the robotic arm420 can ensure a sterile coupling point for the tool assembly 430 andthe robotic arm 420. This permits removal of tool assemblies 430 fromthe robotic arm 420 to exchange with other tool assemblies 430 duringthe course of a surgery without compromising the sterile surgical field.

FIG. 3 illustrates the tool driver 440 in more detail. As shown, thetool driver 440 includes one or more motors, e.g., five motors 442 areshown, that control a variety of movements and actions associated withthe tool assembly 430, as will be described in greater detail below. Forexample, each motor 442 can couple to and/or interact with an activationfeature (e.g., gear) associated with the tool assembly 430 forcontrolling one or more actions and movements that can be performed bythe tool assembly 430, such as for assisting with performing a surgicaloperation. The motors 442 are accessible on the upper surface of thetool driver 440, and thus the tool assembly is configured to mount ontop of the tool driver 440 to couple thereto. The tool driver 440 alsoincludes a shaft-receiving channel 444 formed in a sidewall thereof forreceiving the shaft of the tool assembly 430. In other embodiments, theshaft can extend through on opening in the tool driver 440, or the twocomponents can mate in various other configurations.

FIG. 4 illustrates the tool assembly 430 uncoupled from the robotic arm420. The tool assembly 430 includes a housing or puck 435 coupled to aproximal end of a shaft 436 and an end effector 438 coupled to a distalend of the shaft 436. The puck 435 can include coupling features thatassist with releasably coupling the puck 435 to the tool driver 440 ofthe robotic arm 420. The puck 435 can include gears and/or actuatorsthat can be actuated by the one or more motors 442 in the driver 440, aswill be described in greater detail below. The gears and/or actuators inthe puck 435 can control the operation of various features associatedwith the end effector 438 (e.g., clamping, firing, rotation,articulation, energy delivery, etc.), as well as control the movement ofthe shaft 436 (e.g., rotation of the shaft).

The shaft 436 can be fixed to the puck 435, or it can be releasablycoupled to the puck 435 such that the shaft 436 can be interchangeablewith other shafts. This can allow a single puck 435 to be adaptable tovarious shafts 436 having different end effectors 438. The shaft 436 caninclude actuators and connectors that extend along the shaft and assistwith controlling the actuation and/or movement of the end effector 438and/or shaft 436. The shaft 436 can also include one or more joints orwrists 437 that allow a part of the shaft 436 or the end effector 438 toarticulate relative to the longitudinal axis of the shaft 436. This canallow for fine movements and various angulation of the end effector 438relative to the longitudinal axis of the shaft 436. The end effector 438can include any of a variety of surgical tools, such as a stapler, aclip applier, forceps, a needle driver, a cautery device, a cuttingtool, a pair of jaws, an imaging device (e.g., an endoscope orultrasound probe), or a combined device that includes a combination oftwo or more various tools.

FIG. 5 illustrates an embodiment of a puck 735 and a proximal end of ashaft 736 extending from the puck 735. As shown in FIG. 5, the puck 735includes a plurality of actuation gears and gear shafts that can beeither directly or indirectly controlled by any one of the motors 442associated with the driver 440. For example, as shown in FIG. 5, thepuck 735 is configured to couple to five motors at the locationsindicated by reference numbers M1, M2, M3, M4, and M5. In thisembodiment, puck 735 includes first and second articulation gears G1, G2that are coupled respectively to the first and second motors M1, M2 viaa series of one or more additional gears and shafts. Actuation of thefirst and second motors M1, M2 will rotate the articulation gears G1,G2, which in turn cause linear movement an articulation cable in aproximal or distal direction to thereby cause articulation of the endeffector 438 in desired left and right directions. The puck 735 alsoincludes a shaft rotation gear G3 a that is coupled to the third motorM3 via a series of one or more additional gears and shafts. Actuation ofthe third motor M3 will thus rotate the shaft rotation gear G3 a therebycausing rotation of the shaft 436 of the tool assembly 430. The thirdmotor M3 can also be configured to shift and to couple, via a series ofone or more additional gears and shafts, to a head rotation gear G3 b,which will cause rotation of the end effector 438 relative to the shaft436. The puck 735 further includes a firm close gear G4 a that iscoupled to the fourth motor M4 via a series of one or more additionalgears and shafts. Actuation of the fourth motor M4 will rotate the firmclose gear G4 a to cause linear translation of a drive screw to firmlyclose the jaws of the end effector 438. The puck 735 further includes aquick close gear G4 b that can also couple to the fourth motor M4 via aseries of one or more additional gears and shafts. When motor M4 isshifted into engagement with the quick close gear G4 b, actuation of thefourth motor M4 will rotate the quick close gear G4 b to cause lineartranslation of a quick close cable to quickly close the jaws of the endeffector 438. Finally, the illustrated puck 735 includes a firing gearG5 that is coupled to the fifth motor M5 via a series of one or moreadditional gears and shafts. Actuation of the fifth motor M5 will rotatethe firing gear G5, thereby driving a lead screw linearly to advance asled through the end effector 438.

FIG. 6 illustrates the actuation assembly 870 components of the puck ofFIG. 5. As shown and indicated above, each of the gears G1-G5 is coupledto an actuation shaft that extends from the actuation assembly 870 andalong the shaft 436 of the tool assembly 430, such as for controllingthe movements of the end effector. FIG. 6 illustrates articulationcables 982 that, when actuated (e.g., pushed, pulled, rotated), willcause articulation of the end effector 438 (e.g., movement up, down,left, right, and combinations thereof) relative to the proximal end ofthe shaft 436. The articulation cables 982 are connected to thearticulation couplers 839, shown in FIG. 6, that are driven proximallyand distally when the articulation gears G1, G2 are actuated by thefirst and second motors M1, M2. The actuation assembly 870 also includesan upper rotary driver 984 that when actuated can cause the pair of jawsof the end effector 438 to firmly close. The upper rotary driver 984 iscoupled to the firm close gear G4 a shown in FIG. 6 such that rotationof the firm close gear G4 a by the motor M4 causes rotation of therotary driver 984. The actuation assembly 870 can also include a lowerrotary driver 986 that when actuated can cause movement of a sledlocated at the end effector 438. The lower rotary driver 986 is coupledto the firing gear G5 shown in FIG. 6 and it likewise rotates inresponse to rotation of the firing gear G5. A linear pull cable iscoupled to the quick close gear G4 b shown in FIG. 6 and moves linearlyin a proximal direction to cause rapid close of the pair of jaws.

Two embodiments of bailout mechanisms are disposed in the puck 735 ofFIG. 5 and are configured to engage, drive, reverse, and/or otherwiseaffect the actuation assembly 870 of FIG. 6. As illustrated in FIG. 5, acrank arm 2000 is disposed external to an inner cover 735 i of the puck735 but internal to an outer cover 735 c of the puck 735. The crank arm2000 is disposed on a shaft 2002 extending through an opening or hole inthe inner cover 735 i, and the crank arm 2000 is configured to rotateabout an axis of the shaft 2002. The shaft 2002 is longitudinallyslidable relative to the crank arm 2000, and has a button 2004 on aproximal end thereof. The button 2004 is configured to be manuallypushed distally and is configured to engage the crank arm 2000 throughvarious means, for example pins, tabs, hooks, etc., such that rotatingthe crank arm 2000 will rotate the button 2004 and thus the shaft 2002.The shaft 2002 has a one-way gear 2006 on a distal end thereof. Theone-way gear 2006 has a circular shape with teeth 2006 t extendingdistally from a distal surface thereon. The teeth 2006 t are shaped suchthat they can engage corresponding teeth and apply a rotation force inone direction only, as illustrated in FIG. 7. The shaft 2002 isdisplaced longitudinally proximal to a drive shaft 2020, which has spurgears G5 a and G4 a 1 fixed thereon. Spur gear G5 a is rotatably coupledin a gear train with gears G5 b and G5 c, terminating in the firing gearG5. The spur gear G5 a also has teeth T1 extending proximally from aproximal surface thereof. The teeth T1 correspond to teeth 2006 t andare configured to engage teeth 2006 t and receive a rotation force inone direction only. The spur gear G4 a 1 is rotatably coupled in a geartrain with gears G4 a 2 and G4 a 3, terminating in the firm close gearG4 a. We note that drive shaft 2020 is displaced longitudinally proximalto the motor M3, and is not coupled to motor M3.

A threaded shaft 2030 is disposed laterally from the drive shaft 2020and is disposed proximal to the motors M4, M5. A first end 2030 a of thethreaded shaft 2030 passes through a housing 2032 that is disposed on ashaft 2034 such that the threaded shaft 2030 is rotatable about itslongitudinal axis relative to the housing 2032. The shaft 2034 has aseries of gears fixed thereto. One or more additional gears and shaftsare engageably coupled to the series of gears and the shaft 2034, andare also engaged with the motors M4, M5. As motors M4, M5 are driven,the series of gears on the shaft 2034 are part of gear trains thatengage and rotate spur gear G5 a and spur gear G4 a 1 and ultimately thefiring gear G5 and the firm close gear G4 a. A second end 2030 b of thethreaded shaft 2030 passes through a displacement nut 2036, through ahole in the inner cover 735 i, and through a bailout bolt 2038. Thebailout bolt 2038 rests against an external surface of the inner cover735 i and is fixedly attached to the threaded shaft 2030 such thatrotation of the bailout bolt 2038 rotates the threaded shaft 2030. Thedisplacement nut 2036 is inside the housing and is threadably disposedon and translates along the threaded shaft 2030. Two metal rods 2040 a,2040 b are pivotally fixed to the displacement nut 2036 on a proximaland distal side, respectively, by a variety of different means, such asusing pivot pins, embedding ends of the rods 2040 a, 2040 b therein,etc. The two rods 2040 a, 2040 b extend proximally and distally from thedisplacement nut 2036 and fixedly terminate on gear assemblies 2042 a,2042 b, respectively, that are both part of the gear series on the shaft2034 and that are longitudinally slidable on the shaft 2034. The gearassembly 2042 a couples through gear trains and shafts to the fifthmotor M5 and is part of the gear train that rotates the firing gear G5.The gear assembly 2042 b couples through the gear trains and shafts tothe fourth motor M4 and is part of the gear train that rotates the firmclose gear G4 a. The two rods 2040 a, 2040 b are pivotally fixed on thegear assemblies 2042 a, 2042 b in a variety of ways, such as by pivotpins, embedding ends of the rods 2040 a, 2040 b therein, etc.

During normal operation as illustrated in FIG. 5, the gear assemblies2042 a, 2042 b remain engaged in the gear trains connecting the motorsM4, M5 to the firm close gear G4 a and the firing gear G5, respectively.The motors M4, M5 can cause rotation of the firm close gear G4 a and thefiring gear G5 as explained above. The displacement nut 2036 rests at aninner edge of the inner cover 735 i directly opposite the bailout bolt2038 placed on the outside of the inner cover 735 i. The threaded shaft2030 does not rotate. The shaft 2002 remains in a proximal position,keeping the one-way gear 2006 disengaged from any surrounding gears andthe button 2004 proximal to the crank arm 2000 and the inner cover 735i. The shaft 2002 is kept in a proximal position through frictioninteraction with the hole in the inner cover 735 i through which theshaft 2002 passes, but the shaft 2002 can be kept proximal through avariety of other means, such as by a spring disposed around the shaft2002 between the crank arm 2000 and the button 2004 that will bias theshaft 2002 and the button 2004 proximally. The crank arm 2000 isimmobile. The outer cover 735 c covers all components that are externalto the inner cover 735 i.

When bailout is desired, such as when a malfunction occurs in the endeffector 438 in the firing and/or firm close functions, the outer cover735 c can be removed. A user can manually rotate the bailout bolt 2038,which will cause rotation of the threaded shaft 2030 because the bailoutbolt 2038 is fixed on the threaded shaft 2030. As the threaded shaft2030 rotates, the displacement nut 2036 will translate along thethreaded shaft 2030 toward the housing 2032 because the displacement nut2036 is threadably disposed on the threaded shaft 2030. Movement of thedisplacement nut 2036 will cause the metal rods 2040 a, 2040 b to pivotrelative to the displacement nut 2036 and the gear assemblies 2042 a,2042 b, thereby forcing the gear assemblies 2042 a, 2042 b to moveproximally and distally on the shaft 2034. In particular, the metal rods2040 a, 2040 b will apply proximal and distal forces to the gearassemblies 2042 a, 2042 b as the metal rods 2040 a, 2040 b move towardthe housing 2032 (and consequently toward the shaft 2034) with thedisplacement nut 2036. As the gear assemblies 2042 a, 2042 b moveproximally and distally, the gear assemblies 2042 a, 2042 b will moveout of engagement with the gear trains that engage the motors M4, M5 tothe firm close gear G4 a and the firing gear G5. As illustrated in FIG.8, the gear assemblies 2042 a, 2042 b will move entirely out ofengagement, thus severing any engagement between the motors M4, M5 andthe gears G4 a, G5. When the gear assemblies 2042 a, 2042 b have movedout of engagement of the gear trains, any actuation of the motors M4, M5will have no effect on the actuation assembly 870. The button 2004 canthen be manually pushed distally by a user, which will cause the shaft2002 to move distally. The button 2004 will couple to the crank arm2000, and the teeth 2006 t on the one-way gear 2006 will engage theteeth T1 on the spur gear G5 a. The crank arm 2000 can then be rotatedby a user to rotate the spur gear G5 a, the shaft 2020, and the spurgear G4 a 1 together because they are all fixed to one another. Rotationof the crank arm 2000 causes rotation of the gear trains containinggears G5 a, G5 b, G5 c, and G5 and gears G4 a 1, G4 a 2, G4 a 3, and G4a. The teeth 2006 t, T1 only allow engagement and rotation in onedirection, thus ensuring that rotation of the crank arm 2000 causesretraction and bailout of the firing and firm close functions.

In some embodiments, a hollow outer shaft 2044 extends around the shaft2034 and rests distal to the gear assembly 2042 b. The outer shaft 2044is longitudinally slidable around the shaft 2034 and has one or moretabs 2044 t on a distal end thereof that flare proximally. A channel2046 sized to receive the shaft 2044 extends through a distal end of thepuck 735. During normal operation, the outer shaft 2044 remains at rest,and the tabs 2044 t remain inside the puck 735 and flare out to engageedges of the channel 2046 and prevent the outer shaft 2044 from slidingthrough the channel 2046. During bailout as the gear assembly 2042 b isforced distally as described above, the gear assembly 2042 b contacts aproximal end of the outer shaft 2044 and begins to force the outer shaft2044 distally with continued movement of the gear assembly 2042 b. Asthe outer shaft 2044 is forced distally, the tabs 2044 t are forced intothe channel 2046 and begin to compress because of their proximal flaredshape, allowing the tabs 2044 t and the outer shaft 2044 to enter thechannel 2046. When the gear assembly 2042 b is in its distal-mostposition, the tabs 2044 t will pass entirely through the channel 2046,and the tabs 2044 t and a distal end of the outer shaft 2044 will bepositioned outside the puck 735, as illustrated in FIG. 8. Because ofthe proximal flared shape of the tabs 2044 t, the tabs 2044 t willengage an outer surface of the puck 735 and prevent the outer shaft 2044from being moved entirely back into the puck 735. Protuberance of theouter shaft 2044 prevents the puck 735 from being correctly reengagedwith the tool driver 440, which will prevent the puck 735 from beingused again in a future operation after a bailout was required. Faultypucks may be prevented from being used again through this mechanism.

Another bailout mechanism is illustrated in FIGS. 5 and 8 in the form ofa tool receiver 2050. The tool receiver 2050 is configured to receive atool, such as a hex wrench, and it is displaced longitudinally proximalto the actuation assembly 870. The tool receiver 2050 is fixedlyattached to a shaft 2050 s that is rotatably engaged with the upper andlower rotary drivers 984, 986 through gear engagements inside of theactuation assembly 870. The tool receiver 2050 extends through the innercover 735 i. During normal operation, the tool receiver 2050 rotateswith the actuation assembly 870 and is covered by the outer cover 735 c.When bailout is desired, such as when a malfunction occurs in the endeffector 438 in the firing and/or firm close functions, the outer cover735 c can be removed, and a user can manually insert a tool such as ahex wrench into the tool receiver 2050 configured to receive such atool. The user can then rotate the tool, which causes direct applicationof rotational force to the shaft 2050 s and the upper and lower rotarydrivers 984, 986. The user can reverse and/or retract the firing andfirm close functions by continued rotation of the tool. Various bailoutembodiments can be actuated while the puck is still attached to arobotic arm and/or the bailout can be actuated only after being removedfrom the robotic arm. In other embodiments, linear drive members canalso be uncoupled from any motor and/or gear train and pulled axially tobailout any functions associated with the drive members.

While FIGS. 5 and 8 illustrate various embodiments of bailouts, otherembodiments are possible. Failures in surgical tools can take a varietyof forms and modes, and can require a variety of different responsesdepending on the specifics of each situation. For example, if there is afailure in the motor in which the motor is locked in place, a possiblebailout approach is to disengage a drive gear from a gear train andprovide alternative power to the drive train. The rest of the drivetrain can be parked during the transition. If a motor is free-spinning,an approach can be to stop any free spinning condition before any harmoccurs to the patient and/or the surgical tool by using approaches suchas dampeners or intentional friction or clamps/locks in the system thatcan be overcome but prevents unintentional motion. An approach can alsobe to sense or detect a difference between actual and requested motionto engage a bailout safely, and engage a drive train with another sourceof motor activity to allow a safe bailout and/or replacement. More thanone motor can also be engaged with any critical drive system to accountfor any motor failure. While this approach requires multiple motors percritical drive system, less expensive motors can be used and successfulbailout and/or operation can be assured because of backup motors beingpresent. If failure occurs in a gear train, it can happen in a varietyof ways. For example, a gear train can be locked in place. In such afailure, a bailout approach can be to disengage a distal-most gear andprovide alternative power to the drive train. If a weak link in the geartrain is present and a user and/or the system knows where the weak linkis, an approach can be to disengage the drive train just distal to theweak link and provide alternative power at that location. A weak linkcan also be designed into a system such that a user and/or the systemwill always know which link will fail if a failure occurs. If the geartrain is unable to translate power, an approach can be to stop any freespinning condition before any harm occurs to the patient and/or thesurgical tool by using approaches such as dampeners or intentionalfriction or clamps/locks in the system that can be overcome but preventsunintentional motion. The drive train can be engaged with another sourceof motor activity to allow a safe bailout and/or replacement. If thesystem experiences a loss of controls and/or power, a mechanical bailoutcan be used that does not require power and can be operated entirelymanually. Another approach can be to provide a battery powered backupwithin a robotic arm with sufficient power to return the system to ahome and/or retracted and/or bailout position to allow for safe removaland/or replacement of any malfunctioning components.

FIGS. 9-11 illustrate additional embodiments of bailout mechanisms thatallow for selective bailout of selected functions. FIG. 9 shows a puck3035 similar to the puck 735 of FIG. 5, but which has selective bailoutsfor actuators that are actuated by each motor. The puck 3035 isconfigured to couple to five motors M1, M2, M3, M4, and M5 and includesan actuation assembly with gears similar to the actuation assembly 870that is configured to allow actuation of a variety of functions in anend effector and/or an elongate shaft as explained above with regards toFIGS. 5-8. The puck 3035 however has five openings 3040 through a cover3035 c, with each opening 3040 corresponding to a series of one or moreadditional gears and shafts that engage the motors M1, M2, M3, M4, andM5 to the actuation assembly. Each opening can be covered by a rubbercap 3042 that is sized and shaped to sit in and seal each opening 3040,as illustrated in FIG. 10. The rubber caps 3042 each also seal around abailout gear 3044 disposed in each of the openings 3040. The bailoutgears 3044 have a ledge feature 3050 to ensure a secure seal with eachrubber cap 3042. Each bailout gear 3044 has a cannulated tool receiver3052 on a proximal side thereof and a cannulated shaft receiver 3054 ona distal side thereof and opposite to the cannulated tool receiver 3052.The cannulated tool receiver 3052 is configured to receive a tooltherein, such as a hex wrench, a screw driver, etc. The cannulated shaftreceiver 3054 is configured to receive a proximal end of a drive shaftfrom one of the series of gears and shafts inside the puck 3035 andengaged between the motors M1, M2, M3, M4, M5 and the actuationassembly. Each opening 3040, rubber cap 3042, and bailout gear 3044 isdisplaced longitudinally proximal to a gear and shaft assembly 3046 thatcorresponds with each of the five motors M1, M2, M3, M4, and M5. Asillustrated in FIG. 10, each gear and shaft assembly 3046 has a gear3046 g positioned directly distal to the bailout gear 3044 and fixed ona shaft 3046 s with a proximal end 3046 d of the shaft protrudingproximal to the gear 3046 g. Each cannulated shaft receiver 3054 andeach proximal end 3046 d of the shaft 3046 s are configured to engageone another such that rotation of the bailout gear 3044 causes rotationof the gear 3046 g. For example, the cannulated shaft receiver 3054 canhave a hexagonal opening and the proximal end 3046 d can have ahexagonal cross section. The bailout gears 3044 are coupled to an insideedge 3035 e of the puck 3035 by two springs 3048. The springs 3048 biaseach bailout gear 3044 proximally out of engagement with each shaft 3046s and into each opening 3040.

During normal operation, the rubber caps 3042 are disposed in theopenings 3040 and seal around the bailout gears 3044. The bailout gears3044 are held proximally from the gear and shaft assemblies 3046 by thesprings 3048, and the gear and shaft assemblies 3046 engage with variousgear trains in the puck 3035 to allow the motors M1, M2, M3, M4, M5 toactuate functions in an elongate shaft coupled to the puck 3035 and/oran end effector disposed on a distal end of the elongate shaft.

When bailout is desired, such as when one or more functions of theelongate shaft and/or the end effector fail and need to be reversed, auser can locate the opening 3040 that corresponds to the motor M1, M2,M3, M4, M5 and subsequent gear and shaft assembly 3046 for the functionthat has failed. The user can remove the corresponding rubber cap 3042and place a tool 3056, such as a hex wrench, a screw driver, etc., intothe cannulated tool receiver 3052. Applying distal force to the tool3056 to overcome spring bias from the springs 3048 moves the bailoutgear 3044 distally and into engagement with the proximal end 3046 d ofthe shaft 3046 s of the gear and shaft assembly 3046. The user canrotate the tool 3056, which will cause rotation of the bailout gear 3044and the gear and shaft assembly 3046 and translate into rotation of thecorresponding gear on the actuation assembly. As the corresponding gearon the actuation assembly is rotated, retraction and/or bailout of theselected function occurs. Selected functions can therefore be bailedout, allowing a user to bail out one function without having to bail outall functions at once. A user can, for example, bail out one functionbefore another or only bail out one function in total, thus providinggreater flexibility and ease of use to surgeons during an operation.

There can be a variety of other embodiments. For example, the bailoutgear can include a one-way gear similar to the one-way gear 2006 of FIG.5. In such an embodiment, the bailout gear would not have a shaftreceiver and the gear and shaft assembly would not have a proximal endprotruding above the gears. The bailout gear can also incorporate atorque limiter 3060, as illustrated in FIG. 12. The torque limiter 3060can be incorporated into the bailout gear and can be configured to limita torque applied to the bailout gear and/or the interaction between thebailout gear and the gear and shaft assembly by slipping (as in afriction plate slip-clutch) or by uncoupling the load entirely (as in ashear pin) such that the torque limiter 3060 may protect the gears andshafts within the puck from damage by mechanical overload applied to thetool 3056 by the user.

In the embodiments described in FIGS. 9-11, gears in gear trains withthe actuation assembly remain engaged within their respective geartrains even during bailout. In other embodiments, it is possible forgears to disengage from their respective gear trains when bailout isdesired. For example, FIGS. 13-15 illustrate an embodiment of a gear andshaft assembly 3070 similar to the gear and shaft assembly 3046described above in FIGS. 9-11. As in FIGS. 9-11, the gear and shaftassembly 3070 is disposed within a puck and gears 3072, 3074 engage in agear train between one of the motor M1, M2, M3, M4, M5 and an actuationassembly. A user can access the gear and shaft assembly 3070 through oneor more openings in a cover of the puck, and the user can rotate thegear and shaft assembly 3070 with a tool to bailout a function that hasfailed. However the gear and shaft assembly 3070 provides a mechanism todisengage the gear 3074 from the gear train when bailout is desired. Thegear 3074 is disposed on a shaft 3076 similar to the shaft 3046 s ofFIGS. 9-11. The shaft 3076 has a tool receiver 3078 disposed on aproximal end thereof that is configured to receive a tool for rotatingthe shaft 3076, for example having a slot sized and configured toreceive a screw driver. The shaft 3076 also has a collar 3080 disposedaround the proximal end of the shaft 3076 and that is longitudinallyslidable. The shaft 3076 also has a spring arm 3082 that is coupledadjacent to a proximal end of the shaft and that is configured toflatten and rest in a groove 3076 g on the shaft 3076. The spring arm3082 has a flat portion 3082 f in a middle of the spring arm 3082 sizedand shaped to receive the gear 3074 therearound and configured to slidedistally along the groove 3076 g upon application of distal force on thespring arm 3082. The spring arm 3082 has an extending portion 3082 e ona distal end thereof configured to engage a distal edge of the gear 3074to keep the gear 3074 from sliding distally along the shaft 3076 becausethe extending portion 3082 e is biased proximally.

During normal operation, the gears 3072, 3074 remain engaged with oneanother and remain engaged in a gear train between one or more of themotors M1, M2, M3, M4, M5 and the actuation assembly. The spring arm3082 acts proximally on the gear 3074 to keep the gear 3074 engaged inthe gear train such that actuation of one or more of the motors M1, M2,M3, M4, M5 will translate rotational actuation through the gear trainand to the actuation assembly, thus actuating one or more functions onan elongate shaft and/or an end effector on the elongate shaft. Thecollar 3080 remains proximally displaced from the spring arm 3082 andremains around the tool receiver 3078 through frictional interaction.

When bailout is desired, such as when one or more functions of theelongate shaft and/or the end effector fail and need to be reversed, auser can locate a corresponding opening and the corresponding gear andshaft assembly 3070. The user can place a tool 3084, such as a screwdriver, a hex wrench, etc., onto the tool receiver 3078. Because thecollar 3080 extends around the tool receiver 3078, placing the tool 3084onto the tool receiver 3078 includes contacting and forcing the collar3080 to move distally along the shaft 3076. As the collar 3080 is forceddistally through contact with the tool 3084, the collar 3080 slides overa proximal portion of the spring arm 3082, overcoming a spring bias ofthe spring arm 3082 and forcing the spring arm 3082 to flatten into thegroove 3076 g on the shaft 3076, as illustrated in FIG. 14. As thespring arm 3082 is flattened into the groove 3076 g, the extendingportion 3082 e of the spring arm 3082 flattens with the rest of thespring arm 3082 and disengages from the gear 3074. The extending portion3082 e thus stops providing a proximal force on the gear 3074, and thegear 3074 slides distally through gravitational forces out of engagementwith the gear 3072 and any gear train(s) engaged with one or more of themotors M1, M2, M3, M4, M5. The gear 3074 remains engaged through theseries of gears and shafts to the actuation assembly by, for example,being engaged with an elongate gear that allows continued engagementbetween the gear 3074 and the elongate gear even upon distal movement ofthe gear 3074. As illustrated in FIG. 15, the collar 3080 and the gear3074 can continue to slide distally such that the gear 3074 is entirelyout engagement with any gears engaged with the motors M1, M2, M3, M4,M5, and the spring arm 3082 can return to its position protruding out ofthe groove 3076 g. The tool 3084 can be received into the tool receiver3078, and the user can rotate the tool 3084 to provide rotational forceto the shaft 3076 and bailout a function associated with rotation of theshaft 3076 and the series of gears and shafts between the gear 3074 andthe actuation assembly. Rotational force can be easier on the shaft 3076because the gear 3074 is no longer engaged through any gear trains toone or more of the motors M1, M2, M3, M4, M5, and any actuation of themotors M1, M2, M3, M4, M5 does not translate into rotation of the gear3074 or the shaft 3076. Select functions can thus be bailed out and/orreversed while not affecting other functions and/or functions can bebailed out in a specific order selectable by the user. In variousembodiments, the collar can be manually forced distally to disengage thegear 3074 from the spring arm 3082 if additional force is needed. Whilein this embodiment various gears are entirely disconnected from oneanother, in various embodiments, rather than disconnecting a gear and/orgear train entirely from a motor and/or a drive disk or gear driven by amotor, a drive shaft can experience limited or free rotation while stillbeing attached to the motor and/or the drive disk, for example by beingslip attached by removing keying between the gear and/or gear train andthe drive shaft.

Various embodiments can incorporate indicators that allow a user toidentify which gear and shaft assemblies and/or gear trains might berequired to bail out a failing function on an elongate shaft and/or endeffector and indicate an order of bailout (such as indicating an orderfor which gear and shaft assemblies should be bailed out to retract afiring function before jaw closure function). As illustrated in FIGS.16-18, indicators can take the form of lights 3090, 3092, for exampleLED lights, disposed on an external distal 3094 d and/or proximal 3094 psurface of a puck 3094 similar to the pucks described above. Each light3090, 3092 can be configured to blink, flash, change color, or otherwiseindicate which gear and shaft assembly should be accessed by a user tobail out a failing function. Each light 3092, 3094 can be electronicallycoupled to a control system, such as the control system 315 discussedherein. During operation of the device, the lights 3092, 3094 can beconfigured to indicate a status of various functions, for exampleindicating that all functions are operating normally (such as showing agreen light) or simply remaining in an off state. If there is amechanical failure such as with one or more functions in an elongateshaft 3096 and/or an end effector disposed on a distal end of theelongate shaft 3096 and/or there is some other error requiring bailout,a corresponding light 3090, 3092 can be configured to indicate alocation of the failure and/or error, for example by blinking or turninga different color (such as from green to red). Error locations can beidentified in a variety of ways, as further explored in U.S. patentapplication Ser. No. 15/131,963, filed on Apr. 18, 2016 and entitled“Method for Operating a Surgical Instrument,” incorporated herein byreference. In various embodiments with openings in a cover of a puck toallow selected individual bailout, such as the embodiment describedabove for FIGS. 9-11, lights can be disposed around the openings and canflash or otherwise indicate which opening should be accessed by a userto reverse and/or bail out a failing function. In the embodiment shownin FIGS. 16-18, a portion of a cover of the puck 3094 can be removed bymanually pressing a coupling switch 3098 to disengage the portion of thecover and remove it from the puck 3094, thus allowing a user to directlyaccess any gear and shaft assemblies required to bailout a failingfunction.

While selected individual functions can be bailed out, it is alsopossible to bailout selected functions simultaneously. As illustrated inFIGS. 19-20, a puck 4000 has an outer cover 4000 c and an inner cover4000 i. The puck 4000 is similar to the puck 735 disclosed in FIGS. 5-8,but the puck 4000 allows for simultaneous bailouts of selectedfunctions. As illustrated in FIG. 19, the puck has a crank arm 4002 thatextends through the inner cover 4000 i. Within the inner cover 4000 i,the crank arm 4002 engages a first bailout gear 4004 through teeth 4002t on a distal end of the crank arm 4002. The first bailout gear 4004 isfixedly disposed on a proximal end of a drive shaft 4006, to which asecond bailout gear 4008 is fixedly attached on a distal end thereof.The first bailout gear 4004, the drive shaft 4006, and the secondbailout gear 4008 are configured to rotate together. The puck 4000 hasmultiple gear and shaft assemblies engageably coupled to motors M1, M2,M3, M4, M5 and that are configured to translate actuation of one or moremotors to an actuation assembly similar to that illustrated in FIG. 5.In this embodiment the gear and shaft assemblies have bailout mechanismsdisposed thereon. FIG. 20 illustrates two exemplary gear and shaftassemblies 4020, 4040 with bailout mechanisms therein. Gear and shaftassembly 4020 has a shaft 4022 disposed longitudinally proximal to amotor 4010, such as one of the motors M1, M2, M3, M4, M5, and shaft 4022has a motor coupler 4024 disposed on a distal end thereof that can be,for example, a slot configured to receive a tab on the motor engagement410 that is configured to rotate the shaft 4022 (and consequently aseries of gears and shafts coupled to an actuation assembly not shown inFIG. 20 for the sake of clarity). Shaft 4022 has a gear 4026 fixedthereon that rotates with the shaft 4022 and helps rotate the series ofgears and shafts coupled to the actuation assembly. The shaft 4022 has aspring 4028 disposed therearound proximal to the gear 4026 and justproximal but in contact with a brace 4030 that is fixedly disposed inthe puck 4000. The shaft 4022 slidably passes through a hole in thebrace 4030. A proximal end of the spring 4028 is in contact with asurface of the brace 4030, and a distal end of the spring 4028terminates in a collar 4028 c that is in contact with an arm 4032 a of abailout switch 4032. The collar 4028 c is fixedly attached to the shaft4022 such that longitudinal translation of the collar 4028 c causeslongitudinal translation of the shaft 4022. The bailout switch 4032 isdisposed within the inner cover 4000 i of the puck 4000 and is locatedin a longitudinal groove 4000 g in the inner cover 4000 i. A portion ofthe bailout switch 4032 extends out of the inner cover 4000 i and ismanually slidable longitudinally proximal and distal relative to thecover 4000 i. The arm 4032 a terminates in a u-shaped notch that isconfigured to rest around the shaft 4022 and against a proximal side ofthe collar 4028 c of the spring 4028, thus applying a distal force tothe spring 4028. The spring 4028 biases the shaft 4022 proximally. Aspur gear 4034 is fixedly attached to a proximal end of the shaft 4022such that rotation of the spur gear 4034 causes rotation of the shaft4022.

During normal operations, the bailout switch 4032 is disposed distallyin the groove 4000 g and maintained in position by friction interaction.A distal position of the bailout switch 4032 causes the arm 4032 a torest in a distal position, applying distal force to the collar 4028 cand compressing the spring 4028. The shaft 4022 is held in a distalposition, causing engagement between the motor coupler 4024 of the shaft4022 and the motor 4010.

When bailout is desired, such as when one c functions of an elongateshaft and/or an end effector fail and need to be reversed, a user canremove the outer cover 4000 c and manually move the bailout switch 4032proximally in the groove 4000 g. Proximal movement causes the arm 4032 ato move proximally, allowing the spring 4028 to decompress and force thecollar 4028 c proximally. Movement of the collar 4028 c causes proximalmovement of the shaft 4022, which disengages the motor coupler 4024 ofthe shaft 4022 from the motor 4010. Proximal movement of the shaft 4022does not disengage the gear 4026 from the series of gears and shafts,thus rotation of the gear 4026 is translated to the actuation assemblyby, for example, having the gear 4026 engage with an elongate gear thatremains in engagement with the gear 4026 even with proximal movement.The spur gear 4034 translates proximally with the shaft 4022 such thatthe spur gear 4034 is brought into engagement with the second bailoutgear 4008. Upon pivot of the crank arm 4002, the first bailout gear 4004rotates, causing rotation of the drive shaft 4006, the second bailoutgear 4008, and the spur gear 4034. The shaft 4022 rotates with the spurgear 4034, which rotates the gear 4026 and causes rotation of theactuation assembly through the series of gears and shafts and thebailout of at least one function on the elongate shaft and/or the endeffector.

Bailouts in the puck 4000 are not limited to proximal movement, and canincorporate a variety of different bailout mechanisms. For example, thegear and shaft assembly 4040 can have a lower shaft 4042 disposedlongitudinally proximal to a motor 4012, such as one of the motors M1,M2, M3, M4, M5, and the lower shaft 4042 can have a motor coupler 4044disposed on a distal end thereof that can be, for example, a slotconfigured to receive a tab on the motor engagement 412 that isconfigured to rotate the lower shaft 4042 (and consequently a series ofgears and shafts coupled to an actuation assembly not shown in FIG. 20for the sake of clarity). The lower shaft 4042 has a gear 4046 fixedthereon that rotates with the lower shaft 4042 and helps rotate theseries of gears and shafts coupled to the actuation assembly. The lowershaft 4042 has a distal coupler 4043 on a distal end thereof thatengages with a proximal coupler 4045 on a proximal end of an upper shaft4047, both couplers 4043, 4045 taking the forms of a tab and a slotherein. An arm 4052 a of a bailout switch 4052 extends to engage theupper shaft 4047. The arm 4052 a terminates in a u-shaped notch that isconfigured to rest longitudinally slidably against the upper shaft 4047.The bailout switch 4052 is disposed within the inner cover 4000 i of thepuck 4000 and is located in a longitudinal groove 4001 in the innercover 4000 i. A portion of the bailout switch 4052 extends out of theinner cover 4000 i and is manually slidable longitudinally proximal anddistal relative to the cover 4000 i. The upper shaft 4047 has a spring4058 disposed therearound proximal to the arm 4052 a of the bailoutswitch 4052. A proximal end of the spring 4058 terminates in a collar4058 c that is in contact with the arm 4052 a of the bailout switch4052. The collar 4058 c is fixedly attached to the upper shaft 4047 suchthat longitudinal translation of the collar 4058 c causes longitudinaltranslation of the upper shaft 4047. The spring 4058 is disposed justdistal to but in contact with a brace 4060 that is fixedly disposed inthe puck 4000. The upper shaft 4047 slidably passes through the brace4060 through a hole therethrough. A distal end of the spring 4058 is incontact with a surface of the brace 4060 so that the spring 4058 iscompressed between the arm 4052 a and the brace 4060. The arm 4052 a isconfigured to apply a proximal force against a distal end of the collar4058 c. The spring 4058 biases the upper shaft 4047 distally. A spurgear 4054 is fixedly attached to a proximal end of the upper shaft 4047such that rotation of the spur gear 4054 causes rotation of the uppershaft 4047.

During normal operations, the bailout switch 4052 is disposed proximallyin the groove 4001 and maintained in position by friction interaction. Aproximal position of the bailout switch 4052 causes the arm 4052 a torest in a proximal position, applying a proximal force to the collar4058 c and compressing the spring 4058. The upper shaft 4047 is held ina proximal position, preventing engagement between the upper shaft 4047and the lower shaft 4042 and between the spur gear 4054 and the secondbailout gear 4008. The lower shaft 4042 engages the motor 4012 throughthe motor coupler 4044.

When bailout is desired, such as when one or more functions of anelongate shaft and/or an end effector fail and need to be reversed, auser can remove the outer cover 4000 c and manually move the bailoutswitch 4052 distally in the groove 4001. Distal movement causes the arm4052 a to move distally, allowing the spring 4058 to decompress andforce the collar 4058 c distally. Movement of the collar 4058 c causesdistal movement of the upper shaft, which engages with the lower shaft4042 through the couplers 4043, 4045. Distal movement of the uppersshaft 4047 does not disengage the gear 4046 from the series of gears andshafts, thus rotation of the gear 4046 is translated to the actuationassembly because the gear 4046 is disposed on the lower shaft 4042. Thespur gear 4054 translates distally with the upper shaft 4047 such thatthe spur gear 4054 is brought into engagement with the second bailoutgear 4008. Upon pivot of the crank arm 4002, the first bailout gear 4004rotates, causing rotation of the drive shaft 4006, the second bailoutgear 4008, and the spur gear 4054. The upper shaft 4047 rotates with thespur gear 4054 and causes rotation of the lower shaft 4042 through thecouplers 4043, 4045, and the lower shaft 4042 rotates the gear 4046 andcauses rotation of the actuation assembly through the series of gearsand shafts and the bailout of at least one function on the elongateshaft and/or the end effector. The bailout switches 4032, 4052 can beswitched independently of each other or simultaneously. As illustratedin FIG. 19, a plurality of bailout switches 4052, 4053 can be disposedon the inner case 4000 i of the puck 4000 and correspond to a pluralityof functions in the elongate shaft and/or the end effector. When bailoutis desired, a user can actuate one or more bailout switches, for examplebailout switches 4032, 4052, 4053, and then pivot the crank arm 4002 toeffectively bailout a plurality of function simultaneously.

While the crank arm 4002 as illustrated is a moment arm lever with apawl, the crank arm can take a variety of forms. For example, in otherembodiments a screw head, such as a hex screw head with a ratchetingmechanism, can be used, allowing the insertion of an exterior retractionbar instead of having a fixed arm on the puck. The retraction bar can beratcheted rather than repeatedly rotating any arm. In other embodiments,each drive shaft coupled to a motor can have a screw head. While bailoutswitches in the form of switches in grooves are illustrated in FIGS. 19and 20, a variety of different actuators can be used. For example, thebailout switches can take the form of pull tabs, hooks, buttons, dials,etc. Various embodiments can incorporate indicators that allow a user toidentify which gear and shaft assemblies and/or gear trains might berequired to bail out a failing function on the elongate shaft and/or endeffector. As illustrated in FIGS. 19-20, indicators can take the form oflights 4070, 4072, 4074, for example LED lights, disposed on an externalsurface of the puck 4000, and each light 4070, 4072, 4074 can beconfigured to blink, flash, change color, or otherwise indicate whichgear and shaft assembly should be accessed by a user to bail out afailing function. While three lights are illustrated, a plurality oflights can be used, one for each function and/or one for each motor.Each light 4070, 4072, 4074 can be electronically coupled to a controlsystem, such as the control system 315 discussed above.

During operation of the device, the lights 4070, 4072, 4074 can beconfigured to indicate a status of various functions, for exampleindicating that all functions are operating normally (such as showing agreen light) or simply remaining in an off state. If there is amechanical failure such as with one or more functions in the elongateshaft and/or the end effector disposed on a distal end thereof and/orthere is some other error requiring bailout, a corresponding light, suchas lights 4070, 4072, 4074, can be configured to indicate a location ofthe failure and/or error, for example by blinking or turning a differentcolor (such as from green to red). Error locations can be identified ina variety of ways, as further explored in U.S. patent application Ser.No. 15/131,963, filed on Apr. 18, 2016 and entitled “Method forOperating a Surgical Instrument,” incorporated herein by reference. Invarious embodiments with bailout switches 4032, 4072, 4074 in the innercover 4000 i of the puck 4000, indicators in the form of lights 4070,4072, 4074 can be disposed on one surface of the grooves of the bailoutswitches and can flash or otherwise indicate which switch should beactuated to reverse and/or bail out a failing function. In otherembodiments, such as when the bailout switches are in the form of pulltabs, indicators can be disposed adjacent to the bailout switches.

There are several general aspects that apply to the various descriptionsherein. For example, at least one surgical end effector is shown anddescribed in various figures. An end effector is the part of a surgicalinstrument or assembly that performs a specific surgical function, e.g.,forceps/graspers, needle drivers, scissors, electrocautery hooks,staplers, clip appliers/removers, suction tools, irrigation tools, etc.Any end effector can be utilized with the surgical systems describedherein. Further, in exemplary embodiments, an end effector can beconfigured to be manipulated by a user input tool. The input tool can beany tool that allows successful manipulation of the end effector,whether it be a tool similar in shape and style to the end effector,such as an input tool of scissors similar to end effector scissors, or atool that is different in shape and style to the end effector, such asan input tool of a glove dissimilar to end effector graspers, and suchas an input tool of a joystick dissimilar to end effector graspers. Insome embodiments, the input tool can be a larger scaled version of theend effector to facilitate ease of use. Such a larger scale input toolcan have finger loops or grips of a size suitable for a user to hold.However, the end effector and the input tool can have any relative size.

A slave tool, e.g., a surgical instrument, of the surgical system can bepositioned inside a patient's body cavity through an access point in atissue surface for minimally invasive surgical procedures. Typically,cannulas such as trocars are used to provide a pathway through a tissuesurface and/or to prevent a surgical instrument or guide tube fromrubbing on patient tissue. Cannulas can be used for both incisions andnatural orifices. Some surgical procedures require insufflation, and thecannula can include one or more seals to prevent excess insufflation gasleakage past the instrument or guide tube. In some embodiments, thecannula can have a housing coupled thereto with two or more sealed portsfor receiving various types of instruments besides the slave assembly.As will be appreciated by a person skilled in the art, any of thesurgical system components disclosed herein can have a functional sealdisposed thereon, therein, and/or therearound to prevent and/or reduceinsufflation leakage while any portion of the surgical system isdisposed through a surgical access port, such as a cannula. The surgicalsystems can also be used in open surgical procedures. As used herein, asurgical access point is a point at which the slave tool enters a bodycavity through a tissue surface, whether through a cannula in aminimally invasive procedure or through an incision in an openprocedure.

The systems, devices, and methods disclosed herein can be implementedusing one or more computer systems, which may also be referred to hereinas digital data processing systems and programmable systems.

One or more aspects or features of the subject matter described hereincan be realized in digital electronic circuitry, integrated circuitry,specially designed application specific integrated circuits (ASICs),field programmable gate arrays (FPGAs) computer hardware, firmware,software, and/or combinations thereof. These various aspects or featurescan include implementation in one or more computer programs that areexecutable and/or interpretable on a programmable system including atleast one programmable processor, which can be special or generalpurpose, coupled to receive data and instructions from, and to transmitdata and instructions to, a storage system, at least one input device,and at least one output device. The programmable system or computersystem may include clients and servers. A client and server aregenerally remote from each other and typically interact through acommunication network. The relationship of client and server arises byvirtue of computer programs running on the respective computers andhaving a client-server relationship to each other.

The computer programs, which can also be referred to as programs,software, software applications, applications, components, or code,include machine instructions for a programmable processor, and can beimplemented in a high-level procedural language, an object-orientedprogramming language, a functional programming language, a logicalprogramming language, and/or in assembly/machine language. As usedherein, the term “machine-readable medium” refers to any computerprogram product, apparatus and/or device, such as for example magneticdiscs, optical disks, memory, and Programmable Logic Devices (PLDs),used to provide machine instructions and/or data to a programmableprocessor, including a machine-readable medium that receives machineinstructions as a machine-readable signal. The term “machine-readablesignal” refers to any signal used to provide machine instructions and/ordata to a programmable processor. The machine-readable medium can storesuch machine instructions non-transitorily, such as for example as woulda non-transient solid-state memory or a magnetic hard drive or anyequivalent storage medium. The machine-readable medium can alternativelyor additionally store such machine instructions in a transient manner,such as for example as would a processor cache or other random accessmemory associated with one or more physical processor cores.

To provide for interaction with a user, one or more aspects or featuresof the subject matter described herein can be implemented on a computerhaving a display device, such as for example a cathode ray tube (CRT) ora liquid crystal display (LCD) or a light emitting diode (LED) monitorfor displaying information to the user and a keyboard and a pointingdevice, e.g., a mouse, a trackball, etc., by which the user may provideinput to the computer. Other kinds of devices can be used to provide forinteraction with a user as well. For example, feedback provided to theuser can be any form of sensory feedback, such as for example visualfeedback, auditory feedback, or tactile feedback; and input from theuser may be received in any form, including, but not limited to,acoustic, speech, or tactile input. Other possible input devicesinclude, but are not limited to, touch screens or other touch-sensitivedevices such as single or multi-point resistive or capacitive trackpads,voice recognition hardware and software, optical scanners, opticalpointers, digital image capture devices and associated interpretationsoftware, and the like.

FIG. 21 illustrates one exemplary embodiment of a computer system 100.As shown, the computer system 100 includes one or more processors 102which can control the operation of the computer system 100. “Processors”are also referred to herein as “controllers.” The processor(s) 102 caninclude any type of microprocessor or central processing unit (CPU),including programmable general-purpose or special-purposemicroprocessors and/or any one of a variety of proprietary orcommercially available single or multi-processor systems. The computersystem 100 can also include one or more memories 104, which can providetemporary storage for code to be executed by the processor(s) 102 or fordata acquired from one or more users, storage devices, and/or databases.The memory 104 can include read-only memory (ROM), flash memory, one ormore varieties of random access memory (RAM) (e.g., static RAM (SRAM),dynamic RAM (DRAM), or synchronous DRAM (SDRAM)), and/or a combinationof memory technologies.

The various elements of the computer system 100 can be coupled to a bussystem 112. The illustrated bus system 112 is an abstraction thatrepresents any one or more separate physical busses, communicationlines/interfaces, and/or multi-drop or point-to-point connections,connected by appropriate bridges, adapters, and/or controllers. Thecomputer system 100 can also include one or more network interface(s)106, one or more input/output (IO) interface(s) 108, and one or morestorage device(s) 110.

The network interface(s) 106 can enable the computer system 100 tocommunicate with remote devices, e.g., other computer systems, over anetwork, and can be, for non-limiting example, remote desktop connectioninterfaces, Ethernet adapters, and/or other local area network (LAN)adapters. The IO interface(s) 108 can include one or more interfacecomponents to connect the computer system 100 with other electronicequipment. For non-limiting example, the IO interface(s) 108 can includehigh speed data ports, such as universal serial bus (USB) ports, 1394ports, Wi-Fi, Bluetooth, etc. Additionally, the computer system 100 canbe accessible to a human user, and thus the IO interface(s) 108 caninclude displays, speakers, keyboards, pointing devices, and/or variousother video, audio, or alphanumeric interfaces. The storage device(s)110 can include any conventional medium for storing data in anon-volatile and/or non-transient manner. The storage device(s) 110 canthus hold data and/or instructions in a persistent state, i.e., thevalue(s) are retained despite interruption of power to the computersystem 100. The storage device(s) 110 can include one or more hard diskdrives, flash drives, USB drives, optical drives, various media cards,diskettes, compact discs, and/or any combination thereof and can bedirectly connected to the computer system 100 or remotely connectedthereto, such as over a network. In an exemplary embodiment, the storagedevice(s) can include a tangible or non-transitory computer readablemedium configured to store data, e.g., a hard disk drive, a flash drive,a USB drive, an optical drive, a media card, a diskette, a compact disc,etc.

The elements illustrated in FIG. 21 can be some or all of the elementsof a single physical machine. In addition, not all of the illustratedelements need to be located on or in the same physical machine.Exemplary computer systems include conventional desktop computers,workstations, minicomputers, laptop computers, tablet computers,personal digital assistants (PDAs), mobile phones, and the like.

The computer system 100 can include a web browser for retrieving webpages or other markup language streams, presenting those pages and/orstreams (visually, aurally, or otherwise), executing scripts, controlsand other code on those pages/streams, accepting user input with respectto those pages/streams (e.g., for purposes of completing input fields),issuing HyperText Transfer Protocol (HTTP) requests with respect tothose pages/streams or otherwise (e.g., for submitting to a serverinformation from the completed input fields), and so forth. The webpages or other markup language can be in HyperText Markup Language(HTML) or other conventional forms, including embedded Extensible MarkupLanguage (XML), scripts, controls, and so forth. The computer system 100can also include a web server for generating and/or delivering the webpages to client computer systems.

In an exemplary embodiment, the computer system 100 can be provided as asingle unit, e.g., as a single server, as a single tower, containedwithin a single housing, etc. The single unit can be modular such thatvarious aspects thereof can be swapped in and out as needed for, e.g.,upgrade, replacement, maintenance, etc., without interruptingfunctionality of any other aspects of the system. The single unit canthus also be scalable with the ability to be added to as additionalmodules and/or additional functionality of existing modules are desiredand/or improved upon.

A computer system can also include any of a variety of other softwareand/or hardware components, including by way of non-limiting example,operating systems and database management systems. Although an exemplarycomputer system is depicted and described herein, it will be appreciatedthat this is for sake of generality and convenience. In otherembodiments, the computer system may differ in architecture andoperation from that shown and described here.

The devices disclosed herein can also be designed to be disposed ofafter a single use, or they can be designed to be used multiple times.In either case, however, the device can be reconditioned for reuse afterat least one use. Reconditioning can include any combination of thesteps of disassembly of the device, followed by cleaning or replacementof particular pieces and subsequent reassembly. In particular, thedevice can be disassembled, and any number of the particular pieces orparts of the device can be selectively replaced or removed in anycombination. Upon cleaning and/or replacement of particular parts, thedevice can be reassembled for subsequent use either at a reconditioningfacility, or by a surgical team immediately prior to a surgicalprocedure. Those skilled in the art will appreciate that reconditioningof a device can utilize a variety of techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of the presentapplication.

Preferably, components of the invention described herein will beprocessed before use. First, a new or used instrument is obtained and ifnecessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility.

Typically, the device is sterilized. This can be done by any number ofways known to those skilled in the art including beta or gammaradiation, ethylene oxide, steam, and a liquid bath (e.g., cold soak).An exemplary embodiment of sterilizing a device including internalcircuitry is described in more detail in U.S. Pat. No. 8,114,345 filedFeb. 8, 2008 and entitled “System And Method Of Sterilizing AnImplantable Medical Device.” It is preferred that device, if implanted,is hermetically sealed. This can be done by any number of ways known tothose skilled in the art.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. A surgical tool, comprising: a housing having aplurality of motor-driven drive gears; an elongate shaft extendingdistally from the housing; an end effector coupled to a distal end ofthe elongate shaft; a plurality of actuation assemblies, each actuationassembly being coupled to one of the plurality of motor-driven drivegears such that each of the motor-driven drive gears is configured todrive a corresponding actuation assembly, each actuation assembly beingconfigured to operate a function of the end effector; and a plurality ofbailout mechanisms, each bailout mechanism being selectively engageablewith one of the plurality of actuation assemblies for manually drivingthe actuation assembly.
 2. The surgical tool of claim 1, wherein eachbailout mechanism includes a one-way gear configured to selectivelyengage the actuation assembly and configured to be rotatable in only onedirection to drive the actuation assembly in a reverse direction.
 3. Thesurgical tool of claim 2, wherein the one-way gear is accessible from anexterior of the housing and is configured to move into engagement withthe actuation assembly.
 4. The surgical tool of claim 3, furthercomprising a rotatable lever coupled to the one-way gear, rotation ofthe lever being effective to cause corresponding rotation of the one-waygear.
 5. The surgical tool of claim 1, wherein each actuation assemblyis movable from a first position in which the actuation assembly isengaged with the corresponding motor-driven drive gear, to a secondposition in which the actuation assembly is disengaged with thecorresponding motor-driven drive gear.
 6. The surgical tool of claim 5,wherein each actuation assembly is configured such that it is preventedfrom moving from the second position to the first position.
 7. Thesurgical tool of claim 5, wherein each actuation assembly includes agear mounted on a shaft, the gear being engaged with the correspondingmotor-driven drive gear in the first position, and the gear moving awayfrom and out of engagement with the motor-driven drive gear in thesecond position.
 8. The surgical tool of claim 7, wherein the shaft isconfigured to move with the gear when the gear is moved away from andout of engagement with the motor-driven drive gear, and wherein theshaft includes tabs that engage the housing to prevent movement of theshaft, thereby locking the actuation assembly in the second position. 9.The surgical tool of claim 7, wherein the gear mounted on the shaft ofeach actuation assembly is held in engagement with the correspondingmotor-driven drive gear by a spring, and wherein a collar is disposed onthe shaft and is configured to advance over the spring to release thegear thereby allowing the gear to move out of engagement with themotor-driven drive gear.
 10. The surgical tool of claim 1, furthercomprising a decoupling assembly coupled to first and second actuationassemblies of the plurality of actuation assemblies, the decouplingassembly being configured to simultaneously cause a first gear of thefirst actuation assembly and a second gear of the second actuationassembly to move out of engagement with the corresponding motor-drivendrive gears.
 11. The surgical tool of claim 10, wherein the firstactuation assembly is effective to close opposed jaws of the endeffector, and the second actuation assembly is effective to first aplurality of staples from the end effector.
 12. The surgical tool ofclaim 10, wherein the decoupling assembly includes a threaded shaft anda housing threadably mounted on the threaded shaft, the housing havingfirst and second pusher rods mated thereto and mated to the first andsecond gears such that rotation of the threaded shaft causes translationof the housing such that the first and second pusher rods push the firstand second gears away from the corresponding motor-driven drive gears.13. The surgical tool of claim 1, wherein each bailout mechanismincludes an indicator configured to indicate when the actuation assemblycoupled thereto has failed.
 14. The surgical tool of claim 1, whereinthe bailout mechanism includes a torque limiter.
 15. A surgical bailoutmethod, comprising: selectively actuating a plurality of motors in atool driver of a robotic arm to selectively drive a plurality of drivegears disposed within a housing of a surgical tool, each of theplurality of drive gears driving an actuation assembly extending throughan elongate shaft of the surgical tool to thereby actuate a function ofan end effector of the tool; and selectively moving a first bailoutassembly of a plurality of bailout assemblies into engagement with afirst actuation assembly of the plurality of actuation assemblies, andmanually rotating the first bailout assembly to retract the firstactuation assembly and thereby reverse the corresponding function of theend effector.
 16. The surgical bailout method of claim 15, furthercomprising decoupling the first actuation assembly from engagement withthe corresponding drive gear.
 17. The surgical bailout method of claim16, wherein decoupling the first actuation assembly comprises releasinga spring biasing force applied to a gear of the first actuation assemblyto allow the gear to move out of engagement with the corresponding drivegear.
 18. The surgical bailout method of claim 15, further comprisingsimultaneously decoupling the first actuation assembly and a secondactuation assembly of the plurality of actuation assemblies fromengagement with the corresponding drive gears.
 19. The surgical bailoutmethod of claim 15, further comprising moving the first actuationassembly from a first position, in which a gear of the first actuationassembly is positioned in engagement with a corresponding drive gear ofthe plurality of drive gears, to a second position, in which the gear ofthe first actuation assembly is spaced apart and disengaged from thecorresponding drive gear of the plurality of drive gears.
 20. Thesurgical bailout method of claim 15, further comprising selectivelymoving a second bailout assembly of a plurality of bailout assembliesinto engagement with a second actuation assembly of the plurality ofactuation assemblies, and manually rotating the second bailout assemblyto retract the second actuation assembly and thereby reverse thecorresponding function of the end effector.